1. ABOUT GARDP FOUNDATION

The Global Antibiotic Research & Development Partnership (GARDP Foundation) is a not-for-profit global health organization registered in Geneva, Switzerland. GARDP’s mission is to accelerate the development and access of treatments for drug-resistant bacterial infections. It does so by forging public-private partnerships all over the world to develop and expand access to treatments for serious bacterial infections and sepsis in adults, children and newborns, as well as sexually transmitted infections (STIs).

GARDP Foundation responds to the crisis in antimicrobial resistance. In 2015, the World Health Assembly, the decision-making body of the World Health Organization (WHO), adopted the Global Action Plan on Antimicrobial Resistance. The following year, to deliver on this plan, WHO and the Drugs for Neglected Diseases initiative created GARDP. In 2018, the GARDP Foundation was legally established as an independent entity.

Since then, GARDP Foundation has developed a portfolio of antibiotic treatments that targets WHO priority pathogens, priority diseases and key populations/regions that are especially affected by drug resistance. It is also pioneering new access initiatives with innovator, manufacturing and distribution partners.

As of 2024, the GARDP team consists of about 100 people who collectively share extensive cross-sector R&D and access experience. They work with the key public and private sector stakeholders and partners, such as the research and development community, donors, industry and implementing countries.

2. PROJECT BACKGROUND & PURPOSE OF THE RFP

2.1. Background to project

In 2019, 1.27 million people worldwide died from bacterial antimicrobial resistance (AMR). That same year, more than two in five infection-related deaths linked to AMR occurred in the Americas. In Southern Latin America, the death rate attributable to AMR is the highest globally (18.6). This situation highlights the urgent need to expand access to both existing and new antibiotics in the regioni.

Carbapenem-resistant (CR) Gram-negative bacterial infections caused by Acinetobacter baumannii (CRAB) and Enterobacterales (CRE), and Pseudomonas aeruginosa (CRPA), are listed in the WHO critical and high priority groups, respectively, requiring novel antibiotics for successful treatmentii. CRAB is often resistant due to OXA-type β-lactamases, CRPA due to metallo-β-lactamases (MBL) and CRE due to OXA-type β-lactamases, although many carbapenamases exist, and therefore antibiotics are needed that have activity against a range of different types. CRAB and CRE show an increasing trend in at least 1-3 WHO regions and have a medium-high level of transmissibility. CR bacteria are difficult to prevent and treat, lead to high mortality, and rely on countries having access to the few last line antibiotics. Third-generation cephalosporin-resistant Enterobacterales (3GCRE) are also in the critical group, highlighting the need for new antibiotics to treat those infections too.

Despite the fact that CR and 3GCRE bacteria pose a major public health issue, with limited treatment options and high mortality rates, in many low- and middle- income countries (LMICs) treatment is limited and countries may have inadequate access to safe and effective antibiotics that cover local resistance patterns.iii Further, CR may also be driven by increasing carbapenem use, including to combat increasingly prevalent infections caused by 3GCRE, suggesting that carbapenem-sparing strategies may be needed to treat 3GCRE.

There are only two approved antibiotics with activity against CRAB, cefiderocol and sulbactam-durlobactamiv, which leaves few options, given that GLASS has reported Acinetobacter spp. isolates with over 50% carbapenem resistancev. Furthermore, only cefiderocol is also active against CRPA and CRE.

Cefiderocol is the first clinically available siderophore cephalosporin and has been approved in the USA for the treatment of complicated urinary tract infections (cUTI), and hospital-acquired and ventilator-associated bacterial pneumonia (HABP/VABP), and in Europe for the treatment of infections caused by aerobic Gram-negative bacteria in adults with limited treatment options. The drug is also on the Model List of Essential Medicines (EML) and is recommended as a Reserve antibiotic in the WHO AWaRe antibiotic book, primarily for the treatment of infections caused by MBL-producing CRE and CRPA in adolescents and adults, depending on the type of carbapenemase produced and the resistance mechanismvi. It can be used as monotherapy or potentially with other antibiotics (e.g. to treat CRAB).

Based on a first-of-its-kind license agreement with Shionogi, a collaboration with the Clinton Health Access Initiative (CHAI), and a manufacturing sublicense agreement with Orchid Pharma, GARDP and its partners aim to create new pathways and build sustainable networks to ensure cefiderocol reaches those in need. Cefiderocol is not registered in any country in Latin America.

2.2. Purpose of RFP

GARDP seeks to commission a consultancy firm to conduct a price sensitivity analysis to develop a price-volume matrix for cefiderocol, focusing on both private and public markets in Brazil and Mexico.

Bidders can submit proposal to perform the analysis across the two countries or only just one country.

3. SCOPE OF WORK

Primarily, conduct extensive secondary research and analysis of existing data (in-house and from GARDP) to develop an initial hypothesis for price sensitivity (to be tested through primary research).

After that, build guides and conduct interviews/discussions for price sensitivity. Between 15 and 25 respondents (per country) should be enrolled with a balanced distribution/representation, including but not limited to doctors (treating physicians), hospital administrators/procurement officers, governmental key stakeholders (such as members of technical evaluation committees for Formulary/ Essential Medicines List (EML) inclusions/incorporation of new technologies), and government procurement experts at national and local levels.

The analysis needs to identify key findings and utilize them to develop a price-volume matrix (Excel-based model), as well as assess/benchmark the market prices of competitor products. Furthermore, based on key insights gleaned from the interviews/discussions, the criteria that will impact their “purchasing/procurement” behaviour and price sensitivity should be defined. A model based on this criterion that can provide an idea of what could be the ideal price of cefiderocol for both public and private markets should be developed. Also, pathways and timelines for the inclusion of cefiderocol in state/payor EMLs should be described, noting that cefiderocol is not yet registered in the target countries and the analysis assumes future market entry.

Approximately 5 interviews/discussions with key stakeholders should be carried out to validate the key findings and price-volume matrix, per country.

Expected information to be delivered (per country):

• Price Sensitivity Analysis & Review of Target Price o Key insights on impact of price on adoption in public markets and level of uptake in private markets – from primary and secondary research.

Competitive landscape analysis examining how alternative treatment options (including those currently available) influence acceptable price points and adoption patterns

Price sensitivity analysis and target price range individually for private markets and public markets, using Van Westendorp and Gabor-Granger approaches.

• Margin and Distribution all along the value chain o Map typical value chains for comparable reserve antibiotics, with assessment of likely distribution pathways for cefiderocol

Standard margin structures and value chain illustration individually for the public markets and private markets, with documented ranges for margins at each tier (manufacturer, distributor, wholesaler, pharmacy/hospital)

Estimated acceptable transfer price range for cefiderocol based on price sensitivity analysis and value chain margins, with recommended target pricing for private and public markets that accounts for value chain margins and price sensitivity thresholds (including detailed breakdown showing progressive cost layering from COGS through each distribution tier to final patient/institutional price).

If you are interested to receive the complete documentation, please read and sign attached compliance self declaration and send it to: RFP_Procurement@gardp.org.

Due/closing date: April 17th, 2026